The Cytological Spectrum of Male Breast Lesions - A Peep into the Histopathological Correlation

Background: To study the cytological spectrum of male breast lesions in a tertiary care hospital in South India Materials and Methods: It was a retrospective study of the palpable male breast lumps that were subjected to FNAC over eight years from January 2007 to December 2014. The reports from the archives were analyzed. The diagnoses were categorized as Inadequate, Benign, Indeterminate and Malignant. Histopathological correlation and follow up were studied, wherever available. Results: Out of 3237 breast FNACs, 128 were in males (3.95%). 15/128 were inadequate (11.81%), 101/128 benign (78.90%), 7/128 indeterminate (5.47%) and 5/128 malignant (3.9%). Gynaecomastia was the most common lesion. The spectrum of the diagnosis ranged from inflammatory lesions, gynaecomastia, fibroadenomas, proliferative breast disease without atypia and lipomas in the benign category to infiltrative ductal carcinoma in the malignant category. The indeterminate category included diverse diagnosis. Histopathological correlation was available for 23/128 cases (17.97%). The histopathological diagnosis correlated with cytology in all the malignant cases and 8/9 benign cases. For patients in the benign category who were kept under a conservative management, the non-progression of the lesions on follow up served as a pointer of correct diagnosis. In the indeterminate category, histopathology gave the final diagnosis. Conclusions: FNAC provides a reliable diagnosis in majority of the cases. However, in cases with high degree of clinical suspicion or insufficient material on aspirate, it is advisable to do biopsy for correlation. The most significant role of biopsy remains in cases where FNAC gives a diagnosis in the indeterminate category.